Nursing theories represent an embodiment of knowledge that can be employed or applied in the nursing practice. The original arguments came into existence in the 1800s at a period when the primary focus was emphasized on nursing education. The models create a scope to define and advance nursing care, provide direction for nursing as a practice, and create a footing for basing clinical evidence-based decision-making. Nursing theories are classified in various categories including grand theories that are utilized in a broad scale, middle-range theories which are used for a smaller subset of conditions and the nursing practice theories that are focused on guiding the practice of nursing. Middle-range theories tend to have a narrower scope than the grand and in turn, offer an efficient connection between the grand theories and nursing practice theories. As a result, the models provide concepts and proportions, strategies for client care, and an increasing approach to the nursing field in a theory-based manner. In this paper, we will look at one middle-range theory known as Peplau’s Interpersonal Relations theory and how it can be used to solve the client care problem of nurse fatigue.
Fatigue in the nursing practice is a huge problem in client care and need to be addressed urgently. This issue has been widely documented in the literature as a significant contributor to adverse patient outcomes and poor performance of the profession. Both of these results can compromise the health of nurses and the overall patient care ( Samra & Smith, 2015) . Nurse fatigue is a complex occurrence whose cause is attributed to the personal, organizational, and system factors. In most instances, nurses are forced to work up to long hours in an attempt to compensate for the biting nursing shortage within the organization. In other cases, this fatigue is caused by the monotony of working with patients on a daily basis. Continuous exposure to the same environment and care leads to stress, and thus the person becomes bored and fatigued. They grow weary and tired. Therefore there is a high possibility of clinical errors in the process of client care hence putting the patient safety in danger. Consequently, the nurses become emotionally drained preventing them from conducting their duties correctly as they are discouraged. This ordeal ends up propagating to the entire nursing practice and can also lead to a future shortage of professionals in the nursing discipline. There is a lot of evidence that supports the necessity to adjust the current strategies of practice and adopting a culture that promotes safety. These recommendations recognize the nursing fatigue as a potential risk to the safety of clients and the overall well-being of nurses ( Samra & Smith, 2015) . Studies have indicated that nurses have pointed out that the main reason behind their inability to work is the fatigue.
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Peplau’s Interpersonal Relations theory is one that best describes the solution that can be brought into action to solve the issue of nurse fatigue. This approach amply represents the value of collaboration between the client and the nurse in creating a peaceful environment for the prosperity of both parties. In turn, the partnerships help nurses and caregivers to develop interventions that are therapeutic within the setting of care. The whole point is to strike a shared experience between the nurse and the patient to breed a cohesion that improves the client outcomes.
With the assumption that the nurse and the client can interact, Peplau created a theory that emphasizes the possibility that the two can mature as a result of the therapeutic intervention created ( D'antonio et al., 2014) . She explained the purpose of nursing as a duty of helping other identify the difficulties they face as the caregiver applies the principle of human relations to solve the problems arising from all levels of experience. As nursing is a therapeutic art in that it is aimed at healing, the nurse has to assist the client who is in need of healthcare or is sick. The theory was influenced by Harry Stack Sullivan's Theory of Interpersonal Relations (1953). Here, the theorist wrote several stages of development and their influence on the relationships with others. For an individual to have self-esteem, they have to form several security mechanisms that enhance security. To create this, an individual must be aware of their self. Thus, for the nurse to help the patient, there must be a relationship meant to uphold the client’s dignity and improve their security and self-esteem.
In most cases, the interaction between the nurse and the patient leads to burnout and fatigue. Therefore, the theory can be employed in the development of constructive coping strategies where an individual understands the other and interacts well without compromising anyone’s feelings ( Deane & Fain, 2016) . The constructive coping is a mechanism to prevent the nurse from psychological distress. This strategy involves active efforts to improve, maintain, or sustain an interpersonal relationship ( D'antonio et al., 2014) . For nurses, despite the interaction with patients being a source of distress and fatigue, it can also be a means of enhancing job satisfaction. This comes by implementing the four stages of Peplau’s Theory of Interpersonal Relations which include orientation, identification, exploitation, and resolution. The nurse can begin by getting used to the new client (orientation) defining their problem (identification) after listening to them. The nurse then employs the problem-solving alternatives to address the concern (exploitation). Finally, after the patient’s needs have been met, the two parties can terminate the professional relationship (resolution). This last stage is what determines the maturity of the two sides and leads to their satisfaction.
The primary focus of this theory is that the nurse should understand the patient and help with the techniques earned to aid in their recovery path. The approach can be used to test hypotheses on the prevention of nurse’s burn out and fatigue using therapeutic interpersonal relationships.
References
D'antonio, P., Beeber, L., Sills, G., & Naegle, M. (2014). The future in the past: Hildegard Peplau and interpersonal relations in nursing: Nursing inquiry , 21 (4), 311-317.
Deane, W. H., & Fain, J. A. (2016). Incorporating Peplau’s Theory of Interpersonal Relations to Promote Holistic Communication between Older Adults and Nursing Students: Journal of Holistic Nursing , 34 (1), 35-41
Samra, H. A., & Smith, B. A. (2015). The effect of staff nurses' shift length and fatigue on patient safety and nurses' health: From the National Association of Neonatal Nurses: Advances in neonatal care , 15 (5), and 311
